TY  - JOUR
A1  - Hirschmueller, Anja
A1  - Frey, Victoria
A1  - Konstantinidis, Lukas
A1  - Baur, Heiner
A1  - Dickhuth, Hans-Hermann
A1  - Suedkamp, Norbert P.
A1  - Helwig, Peter
T1  - Prognostic value of achilles tendon doppler sonography in asymptomatic runners
JF  - Medicine and science in sports and exercise : official journal of the American College of Sports Medicine
N2  - HIRSCHMULLER, A., V. FREY, L. KONSTANTINIDIS, H. BAUR, H-H. DICKHUTH, N. P. SUDKAMP, and P. HELWIG. Prognostic Value of Achilles Tendon Doppler Sonography in Asymptomatic Runners. Med. Sci. Sports Exerc., Vol. 44, No. 2, pp. 199-205, 2012. Introduction: Midportion Achilles tendinopathy (MPT) is a common problem in running athletes. Nevertheless, its etiology is not fully understood, and no valid prognostic criterion to predict the development of MPT could be identified to date. The purpose of the present study, therefore, was to evaluate whether power Doppler ultrasonography (PDU) is a suitable method to identify a predisposition to MPT in yet asymptomatic runners. Methods: At 23 major running events, 634 asymptomatic long-distance runners were tested for Achilles tendon thickness, vascularization, and structural abnormalities using a high-resolution PDU device (Toshiba Aplio SSA-770A/80, 12 MHz). In addition, their medical history and anthropometric data were documented. All subjects were contacted 6 and 12 months later and asked about any new symptoms. The collected anamnestic, anthropometric, and ultrasonographic data were subjected to regression analysis to determine their predictive value concerning the manifestation of midportion Achilles tendon complaints (P < 0.05). Results: The highest odds ratio (OR) for manifestation of MPT within 1 yr was found for intratendinous blood flow ("neovascularization,'' OR = 6.9, P < 0.001). An increased risk was also identified for subjects with a positive history of Achilles tendon complaints (OR = 3.8, P < 0.001). A third relevant parameter, just above the level of significance, was a spindle-shaped thickening of the tendon on PDU (Wald chi(2) = 3.42). Conclusions: PDU detection of intratendinous microvessels in the Achilles tendons of healthy runners seems to be a prognostically relevant factor concerning the manifestation of symptomatic MPT. This finding lays the foundation for an early identification of a predisposition to MPT as well as prophylactic intervention in as yet asymptomatic runners.
KW  - MIDPORTION
KW  - TENDINOPATHY
KW  - NEOVASCULARIZATION
KW  - PROGNOSIS
Y1  - 2012
U6  - https://doi.org/10.1249/MSS.0b013e31822b7318
SN  - 0195-9131
VL  - 44
IS  - 2
SP  - 199
EP  - 205
PB  - Lippincott Williams & Wilkins
CY  - Philadelphia
ER  - 
TY  - JOUR
A1  - Hirschmüller, Anja
A1  - Baur, Heiner
A1  - Müller, Steffen
A1  - Helwig, Peter
A1  - Dickhuth, Hans-Hermann
A1  - Mayer, Frank
T1  - Clinical effectiveness of customised sport shoe orthoses for overuse injuries in runners a randomised controlled study
JF  - British journal of sports medicine : the journal of sport and exercise medicine
N2  - Background and objectives Treatment of chronic running-related overuse injuries by orthopaedic shoe orthoses is very common but not evidence-based to date.
 Hypothesis Polyurethane foam orthoses adapted to a participant's barefoot plantar pressure distribution are an effective treatment option for chronic overuse injuries in runners.
 Design Prospective, randomised, controlled clinical trial.
 Intervention 51 patients with running injuries were treated with custom-made, semirigid running shoe orthoses for 8 weeks. 48 served as a randomised control group that continued regular training activity without any treatment.
 Main outcome measures Evaluation was made by the validated pain questionnaire Subjective Pain Experience Scale, the pain disability index and a comfort index in the orthoses group (ICI).
 Results There were statistically significant differences between the orthoses and control groups at 8 weeks for the pain disability index (mean difference 3.2; 95% CI 0.9 to 5.5) and the Subjective Pain Experience Scale (6.6; 2.6 to 10.6). The patients with orthoses reported a rising wearing comfort (pre-treatment ICI 69/100; post-treatment ICI 83/100) that was most pronounced in the first 4 weeks (ICI 80.4/100).
 Conclusion Customised polyurethane running shoe orthoses are an effective conservative therapy strategy for chronic running injuries with high comfort and acceptance of injured runners.
Y1  - 2011
U6  - https://doi.org/10.1136/bjsm.2008.055830
SN  - 0306-3674
VL  - 45
IS  - 12
SP  - 959
EP  - 965
PB  - BMJ Publ. Group
CY  - London
ER  -